Marsupialization of Bartholin’s gland cyst in Ternopil

Marsupialization is an effective method of surgical treatment of a Bartholin's gland cyst, which makes it possible to preserve its functions and reduce the risk of recurrence. It involves the dissection of the cyst cavity and the formation of a new excretory duct from the edges of its capsule. It is carried out in a planned manner, after the acute inflammatory process subsides. Experienced specialists perform such an operation at Viasan MC.

What is a Bartholin’s gland cyst?

Bartholin's paired glands are located in the parenchyma of the labia majora before entering the vagina. During sexual arousal, they secrete a special secret - a viscous grayish-transparent liquid, which provides moisture to the vulva and vagina and performs the function of lubrication during coitus. The glandular secretion is discharged to the inner surface of the labia minora through small (about 2 cm) excretory ducts.

For various reasons, the outflow of secretions from the gland may be disrupted, the excretory canal becomes blocked, thick contents accumulate, forming a cystic cavity. The situation can be aggravated by the addition of a secondary infection, which provokes inflammation of the cyst cavity and the beginning of the purulent process. In some cases, cysts are formed after acute inflammation of the gland (bartholinitis).

A minor violation of secretion outflow usually does not cause much discomfort, does not hurt and does not interfere. The only manifestation of an uncomplicated cyst of the Bartholin's gland is the presence of a round, soft, elastic and mobile formation in the projection of one labia majora (right or left). Usually, this is a one-sided process that is discovered by a woman accidentally or during a gynaecological examination.

With pronounced obstruction of the duct, the cyst increases in size, inflammation progresses, and a secondary infection joins. In the contents of the cystic cavity, an inflammatory (acute bartholinitis) or purulent (abscess) process may develop, which is characterized by:

•     swelling of the labia on the problem side;

•     asymmetry of the genital opening;

•     increase, hyperaemia, tension of the tumour;

•     soreness during palpation, possible fluctuation;

•     excretion of purulent contents;

•     increase in body temperature to 38—39°C;

•     increased inguinal lymph nodes;

•     chills, weakness, deterioration of well-being.

A dangerous complication of a Bartholin’s gland cyst is the spread of the purulent process to nearby organs (cervix, urethra, lymph nodes, etc.), the development of sepsis and transformation into cancer.

Reasons

Obstruction of the duct of Bartholin's gland can be provoked by:

•     conditionally pathogenic flora of the female genital tract against the background of reduced immunity;

•     sexually transmitted bacterial and viral infection (chlamydia, gonorrhoea, HIV, herpes, etc.);

•     acute and chronic inflammation of the gland (bartholinitis);

•     mechanical injuries of the duct;

•     complications after gynaecological surgeries;

•     wearing uncomfortable, tight underwear.

How is the surgery performed?

Marsupialization of a Bartholin's gland cyst is an effective, gentle surgery that allows to avoid recurrence in 99% of cases. But what is important is to preserve the physiological location of the gland and its main function - hydration. This will prevent vaginal dryness due to a lack of natural lubrication. This is an important point regarding the quality of sexual life of women of reproductive age.

The surgery is performed after a standard examination, which includes:

•     laboratory tests of blood and urine;

•     tests for HIV infection, syphilis, hepatitis;

•     fluorography, coagulogram;

•     cytogram of the cervix and swabs for microflora.

The surgery is performed under local anaesthesia in a gynaecological chair. Stages of the surgery:

1.   Aseptic processing of the surgical field.

2.   Carrying out pain-relieving measures.

3.   Introduction of a gynaecological expander into the vagina.

4.   Dissection of the cyst, removal of contents, washing of the cavity.

5.   Formation of an artificial canal connecting the gland with the entrance to the vagina from the shells of the cystic sac.

6.   Manipulations to create a reliable secretion outflow to prevent repeated blockage.

7.   Suturing the wound and treating it with antiseptics.

The surgery lasts about 30 minutes. After completion, the patient spends several hours in the hospital, receives medical recommendations and goes home. Complete healing occurs on the 10-14th day after the surgery.

Advantages of the Viasan Medical Centre

•     A comfortable gynaecological hospital within the walls of a modern multidisciplinary medical centre.

•     Full compliance of the surgery room with international standards.

•     Expert-level specialists with extensive experience in similar surgeries.